Reconstructive surgeries, particularly anterior cruciate ligament (ACL) reconstruction, are well-known in the art. Methods of ACL reconstruction using interference screw fixation are described, for example, in U.S. Pat. Nos. 5,211,647 and 5,320,626. In general, these methods of tenodesis involve drilling a tunnel through the tibia, drilling a closed tunnel (socket) into the femur, inserting a substitute ACL graft into the tunnels, and securing the grafts to the walls of the tibial and femoral tunnels using interference screws or the like.
Other methods of ACL reconstruction include using a button/loop construct for fixation, such as disclosed in U.S. Pat. No. 6,533,802 and U.S. Patent Application Publication No. 2008/0046009. An exemplary method of using a button/loop construct includes the steps of drilling a bone tunnel in an antegrade or retrograde manner, securing a graft (soft tissue or bone-tendon-bone (BTB) graft) to the button/loop construct, passing the graft with button through the bone tunnel, and securing the button to the bone cortex once the button exits the bone tunnel.
The devices and methods of ligament reconstruction of the present invention provide an alternative reconstruction system that employs a fixation device such as a button with a flexible loop attached to a BTB graft, the flexible loop having at least one joined region which may be a bridge of material, a pre-formed knot, a bond or a stitch provided distal to the button, for reproducible graft attachment and improved fixation, graft protection and insertion technique.